1. Urgent Care North Somerset Clinical Commissioning Network

2. Introductions Dr. Kevin Heggarty – Chair, North Somerset Urgent Care Clinical Network Mark Hemmings – Urgent Care Programme Manager, SW Commissioning Support

3. Our Sessions Session 1: Urgent Care animation Challenges and plans! Q&A: listening to your experiences 10 minute break Session 2: Group work Exploring case studies to identify what could add value to the patient experience. The outcomes of this session will help to inform future priorities and planning.

4. Session 1 Setting the scene……. “Urgent Care” – a helpful animation produced by The Kings Fund

5. Transforming Urgent Care: Resources Demand Complexity

6. Real net spending on UK NHS

7. Zero growth until 2017 2017

8. Rising Demand Demographic change Medical advances Patient expectation Failure demand Lifestyle

9. Care mountain High risk Cost Low risk Demand Secondary care RH/NH Primary and Community Care Patients and public

10. Patient System Funding

11. http://www.awp.nhs.uk/ Weston (North Somerset) Urgent Care Working Group Primary Care, Voluntary Action NS, Lay member, Somerset CCG = 14 organisations represented

12. Design principles: 1.Consistent 2.Simple 3.Right first time 4.Efficient and effective

13.  ED front door streaming.  Building a community infrastructure.  ABC raising awareness campaign  Geriatrician team  Care Home Support  7 day working  Enhanced ambulatory care

14. Creating a constantly improving system Clinical engagement Alamac dashboard Building relationships Incident reporting Clinical audits Patient experiences

15. Q&A: Your experiences of urgent care Questions? Experiences? During this session we will try to capture the main points of your experiences and, if possible, use in Session 2 to explore further

16. Session 2 Format - 2 facilitated groups exploring different case studies Ground rules Key questions: – What went well? – What went wrong? – What could have been done differently? We should be continually striving to add value for the patient and eliminate waste

17. What next? We will capture “What you said…..” and put together all your comments, suggestions and ideas. These will be included in the event feedback. Your comments will also be really useful to help shape future priorities and plans Thank you! 10 minute break then regroup in Red Room

18. Case study 1 Working age man Lives with family Develops cough, has discomfort and generally doesn’t feel great Wants GP appointment but can’t afford to take a half day off work Struggles through week On Saturday calls the Out Of Hours doctor Told to go to a primary care centre Diagnosed with a chest infection Needs tests – admitted to hospital

19. Case Study 2 Mum of young children No extended family locally Toddler 18 months consistently at GPs with “fevers” Beginning of Tuesday, toddler is again unwell by evening hot and crying constantly Calls ambulance Paramedic attends Toddler taken to Bristol Children’s Hospital for assessment Siblings cared for by neighbour

20. Case Study 3 36 year old female History of alcohol and drug misuse Recently come out of rehab centre Relapses - starts drinking again Using benzodiazipines Goes to GP who prescribes Diazepam Regularly going to ED in agitated state sometimes intoxicated sometimes in withdrawal from alcohol

21. Case Study 4 86 year old man living alone History of Seen GP Booked to haver injection fiollowing week Pain continues and makes immobile Phones 999 for ambulance Taken to hospital Seen by ED team but relatively junior doctor Suspected DVT – admitted to hospital Stays in several days Discharged with pain relief but less mobile